Screen use and ways to protect pediatric eyesight | Image Credit: © fizkes
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The article by Colleen Sloan, PA-C, RDN, Healthy eyes in a digital world, provides detailed information about the relationship between nutrition and screen time for young children.

Sloan presents the role of fatty acids, flavonoids, carotenoids, and antioxidants, such as Vitamin A, C, and E, along with the specific foods that provide these nutrients in the diet. Pediatric nurse practitioners (PNPs) and all health care providers (HCPs) will benefit from reading this article either as a refresher for nutrients that support eye health or to review new information about the foods that should be included in daily and weekly food choices.

The connection between nutrients and screen time highlights important information for PNPs and all HCPs to consider when providing anticipatory guidance, not only for infants, toddlers, and preschoolers, but for children of all ages, adolescents, and young adults.

For parents who report that their toddler and/or older children, including adolescents, refuse to eat healthy foods that contain essential nutrients for eye health, recommendations for a multivitamin may be appropriate.

Maintaining eye health while exposed to blue light from computer screens

Sloan provides recommendations for nutritional guidance and digital eye health, however, information on possible changes in vision secondary to exposure to blue light emitted from computer screens must also be addressed.

There is a limited amount of research evidence on recommendations for the amount of time that is safe for children and adolescents to be engaged in on-screen activities.

Research studies have focused on internet addiction for school age and/or adolescents,¹ negative behaviors encountered during screen time, such as bullying ² and suicide risk,³ the physical, cognitive, and emotional outcomes of media overuse for school aged children,⁴ electronic media use and sleep patterns,⁵ and sedentary behaviors with an increased risk for obesity.⁶

During the COVID-19 pandemic children and adolescents spent more time on screens, attended classes online, completed homework on computers or tablets, played games online, and spent more time watching television. This extended time on screens was recognized as having the potential to negatively affect eye health leading to refractive errors which was termed "quarantine myopia."⁷

While the authors, Desideri, Barra, and Tovani-Palone did not conduct research studies to investigate whether an increase in refractive errors occurred during COVID-19’s home-schooling periods, they recommended myopia screening and a complete ophthalmological examination for children and adolescents who participated in online learning during COVID-19 stay-at-home mandates.⁷

Today, educators should consider using a variety of educational strategies in classrooms and for homework assignments to reduce overall screen time during learning activities both at school and at home.

Parents should be educated about screen time for their children/adolescents and on the importance of eye health and strategies to preserve eye health. Based on the individual's daily screen time, recommendations may include wearing glasses that block the intensity of blue light emissions from computer screens even if their child’s/adolescent’s eyesight does not require corrective glasses.

Blue light screens are also available for use on computers and tablets. It is important to provide this information to parents, children, and adolescents so that they know the rationale for using protective screens or glasses is to preserve their children's and adolescents; eyesight.

Prioritize eye health anticipatory guidance at each annual visit

The COVID-19 pandemic changed many parts of our lives including the way we conduct our health care visits. Telehealth visits have replaced some visits that in the past would have been in-person visits. Telehealth visits and in-person visits provide opportunities to discuss maintaining healthy eyesight.

Sloan’s insightful article Healthy eyes in a digital World, focuses on nutrition. PNP and all pediatric HCPs' focus on anticipatory guidance presents opportunities to link our usual nutritional anticipatory guidance to eye health, a reduction in extended screen time behaviors, and the benefits of daily planned physical activities.

Click here to view other articles from the November/December issue of Contemporary Pediatrics.

References:

1 Onguner S, Şahin Ş, Akçaboy M, et al. Internet Addiction of School-Age Children and the Effects of Daily Habits. Cyprus Journal of Medical Sciences. 2024;9(4):241-248. doi:10.4274/cjms.2024.2022-23

2 Liu Y, Chen Z, Wang P, Xu L. Relationship between bullying behaviors and physical activity in children and adolescents: A systematic review and meta-analysis. Aggression & Violent Behavior. 2024;78:N.PAG. doi:10.1016/j.avb.2024.101976

3 Coyne SM, Hurst JL, Dyer WJ, et al. Suicide Risk in Emerging Adulthood: Associations with Screen Time over 10 years. Journal of Youth & Adolescence. 2021;50(12):2324-2338. doi:10.1007/s10964-020-01389-6

4 Liu J, Riesch S, Tien J, Lipman T, Pinto-Martin J, O’Sullivan A. Screen Media Overuse and Associated Physical, Cognitive, and Emotional/Behavioral Outcomes in Children and Adolescents: An Integrative Review. Journal of Pediatric Healthcare. 2022;36(2):99-109. doi:10.1016/j.pedhc.2021.06.003

5 Lund L, Sølvhøj IN, Danielsen D, Andersen S. Electronic media use and sleep in children and adolescents in western countries: a systematic review. BMC Public Health. 2021;21(1):1-14. doi:10.1186/s12889-021-11640-9

6 Biddle SJH, García Bengoechea E, Wiesner G. Sedentary behaviour and adiposity in youth: a systematic review of reviews and analysis of causality. International Journal of Behavioral Nutrition & Physical Activity. 2017;14:1-21. doi:10.1186/s12966-017-0497-8

7 Desideri LF, Barra F, Tovani-Palone MR. COVID-19 and Refractive Errors: A New Potential Threat for Children and Adolescents. Electronic Journal of General Medicine. 2021;18(4):1-2. doi:10.29333/ejgm/10870